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Ministry of Health Library

Health Improvement and Innovation Digest

Issue 164 - 29 March 2018

Welcome to the fortnightly Health Improvement and Innovation Digest (formerly the HIIRC digest). The Digest has links to key evidence of interest, with access to new content arranged by topic.

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If you have any queries, please email us at library@moh.govt.nz.

Have you heard about Grey Matter?

We'd like to introduce you to another newsletter that the Ministry of Health Library prepares.  The Grey Matter newsletter provides monthly access to a selection of recent NGO, Think Tank, and International Government reports related to health. Information is arranged by topic, allowing readers to quickly find their areas of interest.  If you'd like to subscribe to Grey Matter, email library@moh.govt.nz

Article access

For articles that aren't open access, contact your DHB library, or organisational or local library for assistance in accessing the full text. If your organisation has a subscription, you may be able to use the icon under full text links in PubMed to access the full article.

Quality Improvement (International)

Update to the Centers for Disease Control and Prevention and the Healthcare Infection Control Practices Advisory Committee Guideline for the Prevention of Surgical Site Infection (2017): A summary, review, and strategies for implementation
Surgical site infections remain a common cause of morbidity, mortality, and increased length of stay and cost amongst hospitalized patients in the United States. This article, published in the American Journal of Infection Control, summarises the evidence used to inform the Centers for Disease Control and Prevention and the Healthcare Infection Control Practices Advisory Committee Guideline for the Prevention of Surgical Site Infection (2017), and highlights key updates and new recommendations.


Hospital Productivity (New Zealand)

Racial disparity in an outreach pediatric surgical service
The aim of this study, published in the Journal of Pediatric Surgery, was to investigate whether racial disparities in healthcare exist within a New Zealand pediatric surgical outreach service in a high indigenous Māori population.


Shorter Stays In Emergency Departments (International)

Impact of the Four-Hour Rule in Western Australian hospitals: Trend analysis of a large record linkage study 2002-2013
In 2009, the Western Australian (WA) Government introduced the Four-Hour Rule (FHR) program. The policy stated that most patients presenting to Emergency Departments (EDs) were to be seen and either admitted, transferred, or discharged within 4 hours. This study, published in PLoS One, utilised de-identified data from five participating hospitals, before and after FHR implementation, to assess the impact of the FHR on several areas of ED functioning.


Primary Health Care (International)

Identification, description and appraisal of generic PROMs for primary care: a systematic review
Patients attend primary care with many types of problems and to achieve a range of possible outcomes. There is currently a lack of patient-reported outcome measures (PROMs) designed to capture these diverse outcomes. The objective of this systematic review, published in BMC Family Practice, was to identify, describe and appraise generic PROMs suitable for measuring outcomes from primary care.

The relationship between health literacy and patient activation among frequent users of healthcare services: a cross-sectional study
Frequent users of healthcare services are a vulnerable population that deserves attention due to high costs and negative outcomes such as lower quality of life and higher mortality. Healthcare systems should offer interventions tailored to their needs and to their level of health literacy, including strategies to promote activation. The relationship between health literacy and patient activation remains to be explored. The aim of this study, published in BMC Family Practice, was to examine the association between health literacy and patient activation in a population of frequent users of healthcare services with chronic diseases.

Patient navigators facilitating access to primary care: a scoping review
Patient navigators are a promising mechanism to link patients with primary care. While navigators have been used in population health promotion and prevention programmes, their impact on access to primary care is not clear. The aim of this scoping review, published in BMJ Open, was to examine the use of patient navigators to facilitate access to primary care and how they were defined and described, their components and the extent to which they were patient centred.

Implementing online consultations in primary care: a mixed-method evaluation extending normalisation process theory through service co-production
The objective of this study, published in BMJ Open, was to examine patient and staff views, experiences and acceptability of a UK primary care online consultation system and ask how the system and its implementation may be improved.

Reduction of antibiotic prescriptions for acute respiratory tract infections in primary care: a systematic review
Although most respiratory tract infections (RTIs) are due to viral infections, they cause the majority of antibiotic (Abx) prescriptions in primary care. This systematic review, published in Implementation Science, summarises the evidence on the effectiveness of interventions in primary care aiming to reduce Abx prescriptions in patients ≥ 13 years for acute RTI.


Primary Mental Health (New Zealand)

Uneven progress in reducing exposure to violence at home for New Zealand adolescents 2001–2012: a nationally representative cross‐sectional survey series
The objective of this study, published in the Australian and New Zealand Journal of Public Health, was to explore trends, and identify risk factors, that may explain changes in adolescent exposure to family violence over time.


Primary Mental Health (International)

Is self-guided internet-based cognitive behavioural therapy (iCBT) harmful? An individual participant data meta-analysis
Little is known about potential harmful effects as a consequence of self-guided internet-based cognitive behaviour therapy (iCBT), such as symptom deterioration rates. Thus, safety concerns remain and hamper the implementation of self-guided iCBT into clinical practice. This study, published in Psychological Medicine, aimed to conduct an individual participant data (IPD) meta-analysis to determine the prevalence of clinically significant deterioration (symptom worsening) in adults with depressive symptoms who received self-guided iCBT compared with control conditions.


Weight Management (International)

The importance of service‐users’ perspectives: A systematic review of qualitative evidence reveals overlooked critical features of weight management programmes
Extensive research effort shows that weight management programmes (WMPs) targeting both diet and exercise are broadly effective. However, the critical features of WMPs remain unclear.  The objective of this systematic review, published in Health Expectations, was to develop a deeper understanding of WMPs critical features. It sought to understand from a service‐user perspective how programmes are experienced, and may be effective, on the ground.

Self-Perceived Cooking Skills in Emerging Adulthood Predict Better Dietary Behaviors and Intake 10 Years Later: A Longitudinal Study
The objective of this study, published in the Journal of Nutrition Education and Behavior, was to determine whether perceived cooking skills in emerging adulthood predicts better nutrition a decade later.


Childhood Obesity (International)

Patterning of neighbourhood food outlets and longitudinal associations with children's eating behaviours
This study, published in Preventive Medicine, examined cross-sectional and prospective associations between typologies of neighbourhood food environment and dietary patterns among 10-12 year-old children.

Comparison of accelerometer measured levels of physical activity and sedentary time between obese and non-obese children and adolescents: a systematic review
Obesity has been hypothesised to be associated with reduced moderate-to-vigorous physical activity (MVPA) and increased sedentary time (ST). It is important to assess whether, and the extent to which, levels of MVPA and ST are suboptimal among children and adolescents with obesity. The primary objective of this study, published in BMC Pediatrics, was to examine accelerometer-measured time spent in MVPA and ST of children and adolescents with obesity, compared with MVPA recommendations, and with non-obese peers.


Māori Innovation

Mahi a Atua: a pathway forward for Māori mental health?
Māori demand on New Zealand mental health services is out of proportion to the size of the Māori population, and the psychiatric service response is limited by lack of capacity. But there is also an inherent lack of capability, that is, the ability of a Western paradigm psychiatric service to meet the needs of an indigenous community. This viewpoint, published in New Zealand Medical Journal, explores the Mahi a Atua narratives-based programme established in the primary mental healthcare services of the Tairāwhiti/Gisborne area. This programme has created a new approach to psychiatric assessment, diagnosis and therapy that is appropriate, but not confined, to the Māori community.


Key Ministry of Health Publications

Immunisation Handbook 2017
The Immunisation Handbook 2017 (the Handbook) provides clinical guidelines for health professionals on the safest and most effective use of vaccines in their practice. These guidelines are based on the best scientific evidence available at the time of publication, from published and unpublished literature.

DataPharm (beta)
DataPharm is a web-based tool (beta version) that displays summary data about prescriptions and dispensings that were dispensed in the community and funded by the New Zealand Government. The data presented is sourced from the Ministry of Health’s Pharmaceutical Collection.


The information available on or through this newsletter does not represent Ministry of Health policy. It is intended to provide general information to the health sector and the public, and is not intended to address specific circumstances of any particular individual or entity.

Ministry of Health - Manatū Hauora
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